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Small renal neoplasms: diagnostic imaging, pathologic features, and clinical course.

N S Curry, S I Schabel, W L Betsill

    Radiology
    |January 1, 1986
    PubMed
    Summary

    Small renal neoplasms (<3 cm) can be aggressive and metastasize. Early detection via computed tomography after screening urography is recommended for unexplained hematuria to improve outcomes for renal cell carcinoma.

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    Area of Science:

    • Urology
    • Oncology
    • Radiology

    Background:

    • Solitary renal neoplasms smaller than 3 cm are often incidentally discovered.
    • These small tumors represent a significant portion of renal neoplasms.
    • Their imaging characteristics, pathology, and clinical course require further investigation.

    Purpose of the Study:

    • To determine the imaging and pathologic characteristics of small renal neoplasms (<3 cm).
    • To evaluate the clinical course and outcomes of patients with these tumors.
    • To assess the metastatic potential and aggressive behavior of small renal neoplasms.

    Main Methods:

    • Retrospective study of nine patients with solitary renal neoplasms <3 cm.
    • Analysis of imaging findings (screening urography, computed tomography) and pathologic characteristics.

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  • Review of clinical course, including diagnosis, treatment (nephrectomy), and follow-up.

    • Main Results:

    • Small renal neoplasms constituted 14% of all renal neoplasms over 6 years.
    • Only one-third were detected by initial screening urography.
    • Two (22%) neoplasms showed aggressive behavior with metastases; one was benign (oncocytoma).
    • Seven patients survived after nephrectomy, with outcomes ranging from 8 months to 6 years.
    • Two renal cell carcinomas were found within calcified renal cysts.

    Conclusions:

    • Small renal neoplasms, including renal cell carcinoma, can exhibit aggressive biologic behavior and metastatic potential.
    • Delayed diagnosis is common, highlighting the need for advanced imaging.
    • Computed tomography is recommended after screening urography and cystoscopy for unexplained hematuria to improve early detection and patient outcomes.